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8. Measurement properties of the EuroQoL EQ-5D-5L to assess quality of life in patients undergoing carpal tunnel release

Author

Marti, C., Hensler, S., Herren, D. B., Niedermann Schneider, Karin, Marks, M., Marti, C., Hensler, S., Herren, D. B., Niedermann Schneider, Karin, and Marks, M.

Abstract

The objective of this study was to investigate the measurement properties of the EuroQol EQ-5D-5L questionnaire (EQ-5D-5L). A total of 60 patients with carpal tunnel syndrome completed the EQ-5D-5L twice before surgical decompression and once more 6 weeks after surgery. In addition, they filled out the Short Form 12 and Michigan Hand Outcomes Questionnaire at the baseline and postoperative follow-up examinations. Test-retest reliability was excellent with an intraclass correlation coefficient of 0.81. Internal consistency was high with Cronbach's alpha of 0.83. Good validity of the EQ-5D-5L was indicated by correlations of r = 0.7 and r = 0.5 with the Short Form 12 and Michigan Hand Outcomes Questionnaire, respectively. Moderate responsiveness was shown by an effect size of 0.5. The minimal important change was 0.09 points. Overall, the EQ-5D-5L demonstrates sound measurement properties and can be recommended as a suitable tool to assess quality of life in patients with carpal tunnel syndrome.

Published
2018

11. Frühresultate des arthroplastischen Grundgelenkersatzes mit der NeuFlex-Silikonprothese

Author

S.F Schindele, B. R. Simmen, Herren D, and M. Flury

Subjects
medicine.medical_specialty, Visual analogue scale, business.industry, medicine.medical_treatment, Implant failure, Silastic, medicine.disease, Arthroplasty, Prosthesis, Surgery, Grip strength, Rheumatoid arthritis, medicine, Orthopedics and Sports Medicine, business, Range of motion
Abstract

For the reconstruction of destroyed metacarpophalangeal (MP) joints in rheumatoid arthritis, the Swanson silicon spacer is still the golden standard. However, long-term follow-up reveals an increasing number of complications, particularly mechanical failure. In order to deal with these problems a number of new, biomechanically different silicone implants have been designed. Among these, the NeuFlex prosthesis has a preflexed hinge of 30 degrees in relation to the shaft axis, a more palmar lying center of rotation and a rectangular hinge with a collarlike platform against the bony surfaces. In a prospective study, the early results of the first thirteen patients operated with the NeuFlex arthroplasty are reported. All patients suffered from rheumatoid arthritis with destruction of the MP joints. The mean follow-up was 12.3 months. A total of 37 joints were replaced. All patients were female with an average age of 56 years. Postoperative reduction of pain, measured on a visual analog scale with the maximum of 10 (VAS), decreased from 6.6 to 0.7 (p < 0.001). Jamar grip strength improved from 4.2 kg preoperatively to 9.9 kg postoperatively (p < 0.005). Range of motion improved from 37 degrees to 57 degrees (p < 0.0001) as a result of a reduction in active extension deficit which reduced from 35 degrees to 15 degrees postoperatively. Ulnar drift was reduced from 20.2 degrees to 3.4 degrees at follow-up (p < 0.005). Radiological evaluation showed no implant failure, no subsidence, and no signs of inflammatory reaction. Overall the NeuFlex silicone implants show encouraging early results which must be confirmed in the long term.

Published
2005
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12. Quality requirements of approved herbal medicinal products

Author

Badertscher Km, Allemann C, and Herren D

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, General Medicine, business
Abstract

Pflanzliche Arzneimittel unterscheiden sich wesentlich von Arzneimitteln mit synthetischen Wirkstoffen. Im Gegensatz zu Synthetika, bei denen als Wirkstoffe chemisch definierte Reinstoffe eingesetzt werden, stellen bei Phytopharmaka die eingesetzten Pflanzen, Pflanzenteile oder -extrakte die Wirkstoffe dar. Besonders wichtig für Phytopharmaka sind deshalb qualitativ hochwertige Rohstoffe und ein standardisiertes Herstellungsverfahren. Der Dokumentation der Qualität eines Phytopharmakons kommt damit eine zentrale Bedeutung zu. Ziel der Qualitätsanforderungen ist ein pflanzliches Arzneimittel von hoher, gleichbleibender Qualität, das eine erfolgreiche, gleichmäßige Therapie gewährleistet. Am 1. Januar 2002 ist das neue Bundesgesetz über die Arzneimittel und Medizinprodukte (Heilmittelgesetz – HMG) in Kraft getreten. Die bisher für pflanzliche Arzneimittel zuständige interkantonale Kontrollstelle für Heilmittel IKS wurde gestützt auf dieses Gesetz aufgelöst und mit der Facheinheit Heilmittel des Bundesamtes für Gesundheit BAG zu Swissmedic, Schweizerisches Heilmittelinstitut, fusioniert. Swissmedic ist damit auch zuständig für Fragen im Zusammenhang mit pflanzlichen Arzneimitteln. Der folgende Artikel gibt einen Überblick über die geltenden Anforderungen an die Qualität pflanzlicher Arzneimittel. Diese stützen sich neu zwar auf das HMG ab, ohne dass inhaltlich Wesentliches geändert hätte.

Published
2002
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15. Commentary on Singh et al. Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation and Smeraglia et al. Trapeziometacarpal arthrodesis: is bone union necessary for a good outcome?

Author

Herren D

Subjects
Male, medicine.medical_specialty, business.industry, Bone union, medicine.medical_treatment, Arthrodesis, Nonunion, Carpometacarpal Joints, medicine.disease, Surgery, Trapezium Bone, Osteoarthritis, medicine, Humans, Internal fixation, Female, Good outcome, business
Published
2015
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29. Comparison of clinical outcome with radiological findings after trapeziectomy with ligament reconstruction and tendon interposition.

Author

Reissner, L., Marks, M., Schindele, S., and Herren, D. B.

Abstract

The aim of our study was to investigate if pre- and postoperative radiographic thumb carpometacarpal position is correlated with clinical and subjective outcomes. Radiographs of 105 patients undergoing trapeziectomy with ligament reconstruction and tendon interposition were analysed before, as well as 1 year after, surgery for dorsal subluxation and proximal migration of the thumb metacarpal bone. Furthermore, key pinch strength was measured and patients completed the Michigan Hand Outcomes Questionnaire. Baseline dorsal subluxation and scaphometacarpal distances significantly decreased from 8.2 mm and 11.0 mm to 5.2 mm and 5.1 mm at 1 year, respectively. There was no correlation between the amount of subluxation or proximal migration and the Michigan Hand Outcomes Questionnaire score or key pinch strength. These results suggest that postoperative position of the metacarpal base of the thumb does not affect clinical or subjective outcomes after trapeziectomy with ligament reconstruction and tendon reposition of the thumb carpometacarpal joint.Level of evidence: Level 3 [ABSTRACT FROM AUTHOR]

Published
2016
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43. Age- and Gender-Specific Normative Data of Grip and Pinch Strength in a Healthy Adult Swiss Population.

Author

WERLE, S., GOLDHAHN, J., DRERUP, S., SIMMEN, B. R., SPROTT, H., and HERREN, D. B.

Subjects
GRIP strength, MUSCLE strength, HAND diseases, OLDER people, DYNAMOMETER
Abstract

Assessment of hand strength is used in a wide range of clinical settings especially during treatment of diseases affecting the function of the hand. This investigation aimed to determine age- and gender-specific reference values for grip and pinch strength in a normal Swiss population with special regard to old and very old subjects as well as to different levels of occupational demand. Hand strength data were collected using a Jamar dynamometer and a pinch gauge with standard testing position, protocol and instructions. Analysis of the data from 1023 tested subjects between 18 and 96 years revealed a curvilinear relationship of grip and pinch strength to age, a correlation to height, weight and significant differences between occupational groups. Hand strength values differed significantly from those of other populations, confirming the thesis that applying normative data internationally is questionable. Age- and gender-specific reference values for grip and pinch strength are presented. [ABSTRACT FROM AUTHOR]

Published
2009
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44. Synthesis, Characterization and Tunable Electronic/Optical Properties of II−VI Semiconductor Species Included in the Sodalite Structure

Author

Moran, K. L., Harrison, W. T. A., Kamber, I., Gier, T. E., Bu, X., Herren, D., Behrens, P., Eckert, H., and Stucky, G. D.

Abstract

The composition-dependent optical and electronic tunability of the sodalite analogues with stoichiometries Zn8X2[BO2]12 (X = O, S, Se) and [CdyZn(1-y)]8X2[BeSixGe(1-x)O4]6 (X = S, Se and Te) have been demonstrated. The materials strongly photoluminesce, and a comparison of the photoluminescence behavior of the single crystals with the as-synthesized powder analogues shows that the visible emission is intrinsic to the sodalite analogue and not due to impurities such as bulk semiconductor. The emission maxima of these materials can be varied by as much as 100 nm with subtle modifications in the host sodalite framework composition and excitation energies can be stored over, at minimum, several minutes. The materials can be prepared either hydrothermally or by high-temperature solid-state reactions. The local and average long-range structures of composition Zn8X2[BO2]12 (X = O, S, Se) and M8X2[BeSixGe1-xO4]6 (M = Zn, Cd; X = S, Se, Te) are described based on the results of polycrystalline X-ray diffraction, multinuclear solid-state MAS NMR, CdL3 XANES, UV/visible and photoluminescence spectroscopic measurements. Additionally, the crystal structures of the synthetic helvite solid solutions Zn8S2[BeSixGe1-xO4]6 (x = 0.03, 0.37, 0.74) are presented based on refinement of single-crystal X-ray diffraction and selected area electron diffraction data; these materials crystallize in the acentric, cubic space group P23 (No. 195) with unit-cell parameters a = 8.250(4), 8.221(2), and 8.163(1) Å, respectively. In all these sodalite analogues, the anionic, rigid sodalite framework encloses [M4X]6+ tetrahedra in a crystalline cubic array, separating each tetrahedron from its eight nearest neighbors by at least 6.4 Å, center to center. This electrostatic isolation results in dramatic high-energy shifts in the optical absorption spectra of the materials and low-frequency shifts in the MAS NMR spectra of the cage center anions, relative to the bulk semiconductors. 113Cd MAS NMR and CdL3 XANES spectra show that the influence of the anion type on the electronic structure at the Cd2+ ions in the cadmium sodalites is small.

Published
1996

49. Options in extensor tendon reconstruction in rheumatoid arthritis

Author

Schindele, S., Kloss, D., and Herren, D.

Subjects
*AUTOIMMUNE diseases, *DRUG therapy, *THERAPEUTICS, *OVERUSE injuries
Abstract

Abstract: There is a decreased incidence of extensor tendon rupture in rheumatoid arthritis due to progress in drug therapy with the consequence that destructive tenosynovitis occurs less often. However, in the long-term course of the disease, the tendons will tend to show signs of attrition at the sharp bone margins as, for example, in caput ulnae syndrome or at Lister''s tubercle. Tendon rupture usually begins ulnarly, progressing over the wrist and extending radially, therefore, the causes of attrition must be remedied to prevent further ruptures. Generally, tendon reconstruction will no longer be possible by primary end-to-end suture at this stage. As the number of ruptures increases, various techniques such as side-to-side suture fixation, tendon transfers or tendon grafting are employed. These techniques will be described below. [Copyright &y& Elsevier]

Published
2006
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50. Complications after treating Dupuytren's disease. A systematic literature review

Author

Stefanie Hensler, C. Krefter, Daniel B. Herren, Miriam Marks, Maurizio Calcagni, University of Zurich, and Herren, D B

Subjects
medicine.medical_specialty, Percutaneous, Dermofasciectomy, medicine.medical_treatment, 610 Medicine & health, Disease, 030230 surgery, Surgical Flaps, Fasciotomy, 03 medical and health sciences, 2732 Orthopedics and Sports Medicine, 0302 clinical medicine, medicine, Humans, Orthopedic Procedures, Orthopedics and Sports Medicine, 10266 Clinic for Reconstructive Surgery, 030222 orthopedics, business.industry, Incidence (epidemiology), Rehabilitation, 2746 Surgery, Surgery, Dupuytren Contracture, 2742 Rehabilitation, Microbial Collagenase, Systematic review, Needles, Microbial collagenase, Complication, business
Abstract

The objective of this study was to review the incidence of complications associated with different treatment options for patients with Dupuytren's disease. In a systematic literature review, the PubMed, EMBASE, Cochrane and Scopus databases were searched for clinical studies reporting complications after collagenase treatment, percutaneous needle fasciotomy (PNF), fasciectomy and dermofasciectomy. The incidence of complications was extracted from each study and stratified by procedure. From a total of 2251 references, 113 studies were analyzed and included with complication incidences varying from 0% to 100%. The highest number of nerve and vessel lesions were reported after fasciectomy, whereas the highest rate of edema was after collagenase injection. Accidental skin tears were mostly associated with collagenase and PNF treatment. Pooled complication incidences were 17.4% (95% CI: 11.7-23.1) for fasciectomy, 78.0% (95% CI: 59.6-96.4) for collagenase treatment, 18.9% (95% CI: -5.5-43.3) for PNF and 11.6% (95% CI: 0.0-23.2) for dermofasciectomy. Due to inconsistencies in reporting complications as well as the lack of a standardized definition, the literature does not provide evidence in favor of a specific procedure for Dupuytren's disease. A standardized definition of complications is required to improve the comparability of published results.

Published
2017
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